West Virginia Office of Miners' Health Safety and Training
Permit Applications and
Reporting Forms
for
Independent
Contractors
The following links
are intended to provide the West Virginia Mining industry and the miners of the
state with downloadable versions of the common applications and documents
required by WVMHS&T. Additional documents will be added as
necessary. General descriptions and instructions are listed with the form
links.
Our forms require Acrobat Reader
to view and download. To
download a free version of the current Acrobat Reader, follow the link above.
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Permitting Application Forms - Independent Contractors
To simplify the permitting process for Independent Contractors, all necessary permit applications are available as a Permit Package. In addition to the permit package, you will need to file a Comprehensive Mine Safety Program, see the links below. All contractors will use the first two downloads, and you will need to select the appropriate Generic Safety Program download for a total of three downloads for the entire permit package.
(1)
Instructions and Permit Package for New
Independent Contractors.
Permit Package (all Contractor permit applications) Revised (9-2010) (for all types of new Contractor Permit Applications)
(2) Initial Submittal Form for filing of a Comprehensive
Mine Safety Program (CMSP).
Initial Submittal Form - CMSP
Revised (9-2010) (for all types of new Contractor Permit Applications)
(3) In addition, all new contractors will need one of the following for their
written Comprehensive Mine Safety Program to be filed with the initial
Submittal Form:
Generic
Safety Program (revised 9-2010) (this should be used by most contractors
including trucking companies).
Generic Comprehensive Mine Safety Program
for Companies Providing Contract Labor at Underground Mines
Generic
Comprehensive Mine Safety Program for Companies Providing Contract Labor at
Surface Mines
Independent Contractor Annual Permit Extension Forms:
Annual Contractor Permit Extension Application Package (fill-able PDF format) Annual Contractor Permit Extension Application Package (non fill-able PDF format) Independent Contractor Annual Permit Extension Application Package contains the forms necessary to apply for an annual extension of the independent contractor permit.
Request for Exemption from the requirements for the independent contractor certificate of approval. (updated)
Reporting Forms
Injury/Accident Report The Injury/Accident form is a two sided form and is to be used for reporting all types of mining accidents. Three copies will need to be filed--follow the instructions on the first page.
Contractor
Reporting Form Independent Contractor Monthly Reporting form. Title 56 Series 10
Note: Monthly Reports may be filed electronically. For more information or to apply for this service use the following link:
Apply for on-line reporting access.
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Note: The information obtained from these documents is accurate to the best of our knowledge and is not a substitute for current mining laws or regulations. The state is not liable for any damages resulting from any information that unintentionally may be inaccurate or untimely.
If you don't find the form you need, or if you have accessibility issues with our forms, please contact us by email (see the link below) and we will assist you. We have attempted to make our forms accessible as required by state and federal regulations.
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Health Safety and Training.
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Date this page was last
updated: 08/05/2011